Clinical
Our clinical nursing articles aim to inform and educate nurse practitioners and students. This is achieved through the publication of peer-reviewed, evidence-based, relevant and topical articles.
Recognition and management of autonomic dysreflexia in patients with a spinal cord...
Why you should read this article • To recognise the signs and symptoms of autonomic dysreflexia • To enhance your understanding of the common causes of autonomic dysreflexia • To update your knowledge of the management of autonomic dysreflexia Autonomic dysreflexia is a potentially life-threatening condition that affects patients with a spinal cord injury at the level of T6 or above. It is characterised by uncontrolled elevation of systolic blood pressure of more than 20mmHg, which may occur alongside bradycardia. This article explains the pathophysiology of autonomic dysreflexia, alongside its causes, signs and symptoms. It also details the pharmacological and non-pharmacological management interventions that should be promptly initiated in patients who present to the emergency department with autonomic dysreflexia, to alleviate their symptoms and prevent further complications.
How safe staffing can improve emergency nursing: time to cut the Gordian knot
Exploring the effects of fatigue, workplace bullying, moral distress and inadequate staffing
Decompression sickness: a guide for emergency nurses
ENs have an essential role in recognising and initially treating patients experiencing DCS
Screening for sepsis: SIRS or qSOFA? A literature review
Evidence from this article led to the creation of a screening tool developed by the author
Assessment and management of patients with tibial plateau fractures in EDs
Such fractures are a common presentation in EDs, yet diagnosis is not always obvious
Emergency healthcare for women who experience intimate partner violence: part 1
This integrative review is the first of a two-part series about intimate partner violence
A comparison of two interventions in the treatment of severe ankle sprains and lateral...
Aim Stable ankle injuries are highly prevalent in the UK. Prevention of complications and reoccurrence is essential. The literature shows that plaster of Paris and AirLoc brace are clinically effective treatments for such injuries. However, there is no research measuring patients’ satisfaction with these treatments. This study compared options in the treatment of severe ankle sprains and distal fibular avulsion fractures from patients’ perspectives. The aim was to determine patients’ preferred treatment between below knee plaster cast and AirLoc brace in the management of stable ankle injuries. Method A total of 39 patients who presented at an urban hospital with stable ankle injuries were recruited into a randomised controlled trial. Patient satisfaction levels were measured by questionnaire one week into treatment. The null hypothesis was ‘there is no significant difference in satisfaction levels between the two devices’. Findings There were statistically significant higher patient satisfaction levels in the AirLoc group compared to the plaster cast group. After analysis by the unrelated t-test, the null hypothesis was rejected. Comfort, daily activities, sleep, work and social life were the main contributing factors. Additionally, 67% of the AirLoc group compared to 46% of the plaster cast group were able to return to work. The number needed to treat for one additional AirLoc patient to return to work was 4.8 (five patients). Conclusion Patients’ preferred treatment is the AirLoc brace. The inquiry method could be used to provide patient-centred care in other fields.
Awareness of secondary traumatic stress in emergency nursing
Nurses should take the necessary steps to safeguard against secondary traumatic stress
Time is precious: person-centred end of life care in an emergency department
A quality improvement project undertaken in one ED at a major tertiary referral hospital
Reducing attendance at trauma clinics by providing first-point-of-contact treatment
Implementing trauma pathways in two of Oxfordshire’s community minor injury units
Full-thickness burns due to contact with gastric acid
This article highlights the potential harm caused by gastric acid
How ED four-hour target affects clinical outcomes for people with a personality disorder
This article challenges the perception of the target as beneficial for all patients